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Helicobacter pylori Infection Is Not Associated with Subclinical Hepatic Encephalopathy in Stable Cirrhotic Patients

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Abstract

The importance of ammonia-producing Helicobacter pylori infection as a cause of subclinical encephalopathy in cirrhosis was investigated. In addition, a single psychometric test that can reliably detect subclinical hepatic encephalopathy was sought. Out-patients with cirrhosis and no overt encephalopathy underwent [14C]urea breath testing once and psychometric testing on two separate occasions, with an intervening course of clarithromycin/omeprazole if they had subclinical encephalopathy (two of four psychometric tests abnormal). Subclinical encephalopathy was present in 27 of 69 patients (39%), and Helicobacter pylori infection in 14 of 69 (20%). There was no association between the two conditions (P = 0.769). Subclinical encephalopathy resolved in 75% of treated Helicobacter pylori-positive patients and 37.5% of treated Helicobacter pylori-negative patients (P = 0.285). Number connection test-B had high reproducibility among untreated patients (R = 0.655) and high correlation (P ≤ 0.01) with three surrogate gold standards. In stable cirrhotic patients, subclinical hepatic encephalopathy was found to: (1) have a high prevalence, (2) not be associated with Helicobacter pylori infection, and (3) be readily detected with the number connection test-B alone.

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Authors and Affiliations

  1. Division of Gastroenterology, Brigham & Women's Hospital, Boston, Massachusetts

    Ilias A. Scotiniotis

  2. Division of Gastroenterology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania

    Michael R. Lucey & David C. Metz

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  1. Ilias A. Scotiniotis
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  2. Michael R. Lucey
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  3. David C. Metz
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Scotiniotis, I.A., Lucey, M.R. & Metz, D.C. Helicobacter pylori Infection Is Not Associated with Subclinical Hepatic Encephalopathy in Stable Cirrhotic Patients. Dig Dis Sci 46, 2744–2751 (2001). https://doi.org/10.1023/A:1012787731821

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